肥胖低通气综合征与阻塞性睡眠呼吸暂停低通气综合征的临床特点比较分析

发布时间：2018-02-15 14:00

本文关键词： 肥胖低通气综合征阻塞性睡眠呼吸暂停低通气综合征临床特点　出处：《石河子大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的探讨肥胖低通气综合征(OHS)和阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的临床特点方面异同,为临床工作中正确鉴别两病提供依据。方法应用病例对照研究为研究方法,选取2010-2015年新疆维吾尔自治区人民医院收住院治疗的OHS患者35例、OSAHS患者45例,进行两组间临床资料的收集、归纳、统计学计算及分析。结果OHS组与OSAHS组年龄和性别比例差异无统计学意义(P0.05)。OHS组35人,有吸烟史者28人,OSAHS组45人,有吸烟史者35人,经四格表资料卡方检验,P0.05,差异无统计学意义。两组的BMI、颈围、腰围用均数±标准差(±s)的形式表示分别为35.6±4.8、50.6±7.2、113±10.1,29.3±4.2、37±2.1、98.2±8.1,经t检验进行组间比较,差异具有统计学意义(P0.05)。OHS组患者比OSAHS组患者更易发生白天嗜睡,本研究发现OHS组患者ESS评分平均值更高,两组此指标的差异具有统计学意义,OHS组患者相比OSAHS组患者记忆力减退、晨间头痛、下肢水肿、晨起口干、夜间睡眠憋醒这些临床症状更常见,两组差异有统计学意义(P0.05)。夜尿增多差异无统计学意义。两组的日间清醒状态的Pa O2、Pa CO2,PSG监测的最低血氧饱和度、平均血氧饱和度、氧饱和度90%时间、呼吸暂停低通气指数(AHI)、低通气平均持续时间差异有统计学意义(P0.05)。睡眠呼吸暂停持续时间差异无统计学意义(P0.05)。OSAHS组患者的肺功能检测结果提示,FEV1、FVC、FEV1/FVC、MVV、VC一般在正常范围,OHS组患者的FEV1、FVC、MVV、VC、FEV1/FEV1pred这些指标一般都有降低,与OSAHS组进行比较差异具有统计学意义,两组的FEV1/FVC都一般在正常范围,差异不具有统计学意义。OHS组与OSAHS组比较,OHS组合并高血压、冠心病、认知障碍、脑血管疾病、II型呼吸衰竭的病例数更多,且差异有统计学意义(P0.05)。结论OHS患者与OSAHS患者相比:肥胖程度更重,发生临床症状机率及种类更多且程度更重,肺功能多表现为限制性通气功能障碍,睡眠监测提示缺氧程度会更重且持续时间一般更长,发生并发症的机率更多。
[Abstract]:Objective to explore the differences and similarities of the clinical characteristics between the patients with obesity hypopnea syndrome (OHS) and obstructive sleep apnea hypopnea syndrome (OSAHS), and to provide evidence for the correct differentiation of the two diseases in clinical work. From 2010 to 2015, 35 OHS patients who were hospitalized in Xinjiang Uygur Autonomous region people's Hospital were selected to collect the clinical data between the two groups. Results there was no significant difference in age and sex ratio between OHS group and OSAHS group. There was no significant difference between the two groups in terms of BMI, neck circumference and waist circumference (卤s) in the form of mean 卤standard deviation (卤s), which were respectively 35.6 卤4.80.63 卤7.2C, 113 卤10.1C, 29.3 卤4.2U, 37 卤2.1 卤98.2 卤8.1, and were compared between the two groups by t-test. The difference was statistically significant (P 0.05). OHS group was more prone to daytime sleepiness than OSAHS group. This study found that the average value of ESS score in OHS group was higher than that in OSAHS group. The difference between the two groups was statistically significant. Clinical symptoms such as morning headache, edema of the lower extremities, dry mouth in the morning and sleep at night are more common. There was significant difference between the two groups (P 0.05). There was no significant difference in nocturnal urine. The lowest oxygen saturation, mean oxygen saturation and oxygen saturation 90% time were monitored by Pao _ 2O _ 2 CO _ 2P _ 2P _ 2P _ (2) G in daytime awake state of the two groups, and no significant difference in nocturnal urine was found between the two groups. Apnea hypopnea index (AHI) and mean duration of hypopnea were significantly different (P 0.05). There was no significant difference in sleep apnea duration (P 0.05). The results of pulmonary function test in patients with OSAHS suggested that FEV1 / FVCV 1 / FVC1 / MVVV VC was generally in normal range of OHS group. Patients' FEV1 / FEV1 / FEV1 / FEV1pred were generally reduced. The difference between OHS group and OSAHS group was statistically significant. The FEV1/FVC of the two groups were in normal range, but the difference was not statistically significant. OHS group was compared with OSAHS group in combination with hypertension, coronary heart disease, cognitive impairment, and no significant difference was found between OHS group and OSAHS group. The number of patients with type II respiratory failure of cerebrovascular disease was more, and the difference was statistically significant (P 0.05). Conclusion compared with OSAHS patients, OHS patients are more obese, have more clinical symptoms, and have more kinds of clinical symptoms. Pulmonary function is usually characterized by restricted ventilation dysfunction. Sleep monitoring indicates that hypoxia is more severe and lasts longer and complications are more likely.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R766;R589.2

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